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v1.0.0
ICD-10 Guide
ICD-10 CodesO34.43

O34.43

Billable

Maternal care for other abnormalities of cervix, third trimester

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/08/2025

Code Description

ICD-10 O34.43 is a billable code used to indicate a diagnosis of maternal care for other abnormalities of cervix, third trimester.

Key Diagnostic Point:

O34.43 refers to maternal care for abnormalities of the cervix that may arise during the third trimester of pregnancy. These abnormalities can include cervical incompetence, cervical polyps, or other structural anomalies that may pose risks to the pregnancy. In the context of maternal care, it is crucial to monitor these conditions closely as they can lead to complications such as preterm labor or delivery. The presence of a previous cesarean section or uterine scarring can further complicate the management of these cervical abnormalities, necessitating a multidisciplinary approach to care. Regular assessments, including cervical length measurements via ultrasound, may be performed to evaluate the risk of premature birth. Additionally, patients may require interventions such as cervical cerclage or increased surveillance during labor and delivery to ensure maternal and fetal safety. Proper documentation of these conditions and their management is essential for accurate coding and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in documentation of cervical abnormalities
  • Need for detailed history of previous obstetric surgeries
  • Differentiation between types of cervical abnormalities
  • Potential for multiple concurrent obstetric conditions

Audit Risk Factors

  • Inadequate documentation of cervical assessments
  • Failure to note previous obstetric history
  • Misclassification of cervical abnormalities
  • Lack of clarity in treatment plans

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Documentation must include detailed descriptions of cervical examinations, any interventions performed, and the patient's obstetric history.

Common Clinical Scenarios

Patients with a history of cervical surgery presenting with cervical abnormalities in the third trimester.

Billing Considerations

Consideration of the patient's previous obstetric history, including cesarean deliveries and uterine scarring, is critical for accurate coding.

Maternal-Fetal Medicine

Documentation Requirements

High-risk pregnancy documentation must include comprehensive assessments of cervical length and any interventions such as cerclage.

Common Clinical Scenarios

Management of patients with cervical incompetence and a history of preterm labor.

Billing Considerations

High-risk factors must be clearly documented to justify the complexity of care and coding.

Coding Guidelines

Inclusion Criteria

Use O34.43 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that all relevant clinical information is documented to support the use of O34
  • Specific criteria for cervical abnormalities must be met

Exclusion Criteria

Do NOT use O34.43 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

59400CPT Code

Obstetric care including antepartum care, delivery, and postpartum care

Clinical Scenario

Used for comprehensive obstetric care in patients with cervical abnormalities.

Documentation Requirements

Complete documentation of all prenatal visits and any interventions related to cervical care.

Specialty Considerations

Obstetricians must ensure that all aspects of care are documented to support billing.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of cervical abnormalities, improving the accuracy of claims and the ability to track outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of cervical abnormalities, improving the accuracy of claims and the ability to track outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of cervical abnormalities, improving the accuracy of claims and the ability to track outcomes.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are the implications of coding O34.43?

Coding O34.43 indicates that the patient is under care for cervical abnormalities, which may require additional monitoring and interventions. Accurate coding is essential for appropriate reimbursement and quality of care.